Original reportsCancer Research Studies in Native Hawaiians and Pacific Islanders
Introduction
Cancer is a major public health problem among Native Hawaiians and other Pacific Islanders 1, 2, 3, 4, 5, 6, 7, 8, 9. Cancer studies in Native Hawaiians have been mainly epidemiological and have rarely focused on clinical research and interventions (10). Furthermore, there is a scarcity of published data on cancer in the U. S. associated Pacific Island populations 7, 11. Major gaps exist in available data on cancer risk, incidence, survival, mortality as well as knowledge, attitudes, and behavior regarding cancer in these Pacific Island populations.
During the 1990s, significant declines in U.S. cancer mortality rates for males and females combined have been reported for whites, African Americans, and Hispanics 12, 13, 14. The decline in U.S. cancer mortality rates have been attributed to research advances in prevention, screening and early detection, and clinical treatment. In sharp contrast to whites, African Americans, and Hispanics, the Native Hawaiian population has experienced an increase in cancer deaths for all cancers combined and for the 13 most common cancer sites, with the exception of stomach cancer 2, 15. Native Hawaiians and Pacific Islanders can benefit from relevant cancer research studies conducted in other medically underserved populations. In addition, cancer research can provide important strategies for the development of culturally sensitive cancer prevention and control programs.
The current study uses published data from population-based cancer registries, cancer epidemiology studies, and clinical cancer research studies on Native Hawaiians and other Pacific Islanders to: (i) examine the patterns of cancer incidence among these various ethnic groups; (ii) review research findings from pertinent cancer research studies; (iii) assess the implications of the research findings; (iv) articulate gaps in data and lack of culturally relevant interventions and recruitment strategies; and (v) make recommendations for future research studies.
Section snippets
Methods
This study is based on data collected primarily from published reports on cancer surveillance, epidemiological, and clinical studies of cancer in Native Hawaiians and other Pacific Islanders. Studies were obtained for review by searching MEDLARS, the National Library of Medicine's computerized information system, using MEDLINE (a bibliographic database of published biomedical journal articles) for titles and abstracts of articles published between 1966 and 1998. BIOSIS Previews (a bibliographic
Demography
Native Hawaiians are a distinct and unique indigenous people with a historical continuity to the original inhabitants of the Hawaiian archipelago, whose society was organized as a nation before the arrival of the first foreigners in 1778 (16). Native Hawaiians constitute between 12 and 19% of the State of Hawai`i's population of 1,108,229 (17). The lower percent reflects underenumeration of Native Hawaiians in the 1990 census (18). The 19% is the accepted state enumeration based on the Hawai`i
Discussion
The paucity of published reports reflects the lack of cancer research studies among these populations. Much of the research on Native Hawaiians and Pacific Islanders focused on cancer surveillance and epidemiology studies and included few clinical research studies. Native Hawaiians were found to be the focus of the largest number of published cancer studies that focused primarily on descriptive epidemiological studies and a community-based educational intervention research study. Ample data on
Recommendations
The results obtained from this review of the published literature on cancer research studies in Native Hawaiians and Pacific Islanders support the need for research targeting cancers that affect Native Hawaiians and Pacific Islanders. Although cancer is a major public health concern among these populations, the documented cancer burden and mortality varies widely among these groups, and therefore, more uniform and systematic surveillance of cancer incidence, mortality, and survival is needed.
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Cancer epidemiology in the small nations of Pacific Islands
2017, Cancer EpidemiologyCitation Excerpt :In addition to other NCDs, the burden of cancer is increasing in the PICTs; however, evidence is limited due to low coverage and suboptimal quality of cancer registration and paucity of reliable mortality data, especially data on causes of deaths [3,4]. Since the report on cancer incidence in the Pacific region published in 1985 [5], cancer epidemiology in the PICTs has been reviewed by several authors [3,4,6–9]. Dachs et al. examined cancer disparities in indigenous Polynesian populations and found disproportionately higher cancer mortality in Polynesian people compared with Europeans living in New Zealand and Hawaii, whereas data were limited on indigenous disparities in Polynesian people living in Pacific Islands [3].
Cancer disparities in indigenous Polynesian populations: Māori, Native Hawaiians, and Pacific people
2008, The Lancet OncologyCitation Excerpt :The Christchurch Tissue Bank for research reported that 5·1% of donors were Māori, 0·5% Samoan, and most of the remainder were European New Zealanders, a distribution similar to that of the regional population ethnicity distribution.88 In Hawaii, not only is there an absence of systematic data collection on cancer incidence and mortality in Pacific people, but, together with Native Hawaiians, Pacific people are less likely to be included in clinical studies than European people, with only 0·1% of participants being Native Hawaiian in a cancer prevention trial and only 0·5% of participants being of Pacific ethnicity in a cancer screening trial.10 Nonetheless, the Cancer Research Centre of Hawaii runs national and international trials.89
Breast cancer screening among Chamorro women in California
2008, Cancer Detection and PreventionCitation Excerpt :Specifically, compared to women who reported that they did not know how frequently they should have a screening mammogram (42.9%), those who reported that they should have one annually (88.2%) were more likely to have had the test (p = .002). Compared with other Pacific Islanders [2,12,13] and certain Asian populations, the screening rates within this self-selected San Diego cohort of Chamorros exceeded those of others. Approximately 76% of the Chamorro women age 40 and older reported having received a mammogram within the preceding two years.
Thyroid Cancer Incidence, Clinical Presentation, and Survival Among Native Hawaiian and Other Pacific Islanders
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